Weight Gain During Pregnancy
When I was 20 weeks pregnant, a doctor told me I should “slow down” my weight gain. Here’s why I think doctors need to be more considerate when addressing weight gain during pregnancy.
Weight gain during pregnancy — it’s a sensitive subject. On the one hand, we want to protect babies from the detrimental effects of disorders associated with excessive weight gain such as gestational diabetes and preeclampsia. On the other hand, I believe obstetricians have become overly cautious about what is often normal, healthy growth.
In some cases, this hypervigilance is merely disheartening to a woman trying to embrace her changing body, in other cases, it could lead to a full-fledged spiral with harmful outcomes for both her and her unborn baby.
WEIGHT GAIN DURING PREGNANCY AND EATING DISORDERS
The thing is, pregnancy is not the time to make a woman feel bad about her weight. Studies suggest that as many as 75% of American women have disordered eating behaviors or report symptoms of eating disorders. Meanwhile, women with a history of eating disorders have higher rates of miscarriage, small for gestational age babies, low birth weight babies, babies with microcephaly, intrauterine growth restriction, and premature labor.
If you subscribe to an intuitive eating food philosophy, then you know that dieting and obsessing about weight frequently leads to disordered eating behaviors, and in extreme cases, eating disorders.
So you would think that it would be a top priority for OBs to avoid making their pregnant patients feel bad about their weight gain. You’d think they’d be sensitive when dealing with a population so susceptible to the harms of diet mentality. But shockingly, this is something that is all too common.
WHEN YOUR OB SAYS YOU’RE GAINING TOO MUCH WEIGHT
At my 20-week ultrasound during my recent pregnancy, I was overcome with joy to see my baby on the monitor. As we gushed over a photo of him sucking his tiny thumb in utero, the doctor happily informed us that our little boy looked healthy and everything was progressing normally. Then she switched gears.
“How much weight have you gained so far?” she asked.
“About 15 pounds,” I responded.
“Well, you might want to slow down a little,” she remarked.
I could feel my blood start to boil. “Why is that?” I asked.
“Well, we just want to make sure you don’t gain too much,” she explained. “You don’t want to have to push out a 10-pound baby.”
She then proceeded to tell us that Caleb was on the larger side of normal – landing in the 90th percentile for size.
“How have you been eating,” she continued to prod (a question any dietitian would naturally take offense to).
I politely informed her that I wasn’t “eating for two” – as she so kindly informed me wasn’t an appropriate dietary strategy (duh) – and that I continued to eat the same well-balanced, predominantly plant-based foods I’d eaten prior to pregnancy. I enjoyed treats here and there (#balance) but nothing out of the ordinary.
She suggested I start taking nightly walks. Had I not been so incensed at this point, I would have laughed. I was still doing 4-5 hour-long studio workouts per week at this point.
My husband could sense the wrath of Whitney beginning to rise and we quickly wrapped up the appointment.
When we got to the car, I unloaded. I’m a dietitian, an avid exerciser, and thankfully, I’d been feeling pretty good about my body and weight so far – who the $#@% was she to come at me with that? My husband sympathized with my frustration but I could tell he was also a little concerned. I mean, if a doctor tells you there’s a problem…
NORMAL WEIGHT GAIN RECOMMENDATIONS DURING PREGNANCY
The real problem, I believe, is how we define healthy weight gain during pregnancy.
The current recommendations for weight gain during pregnancy are:
- Underweight: 28-40 lbs
- Normal weight: 25-35 lb
- Overweight: 15-25 lbs
- Obese: 11-20 lbs
This weight comes from the fetus, expansion of maternal tissues, increases in uterine and mammary tissue mass, expansion of maternal blood volume, extracellular fluid, fat stores, and possibly other tissues.
The biggest issue is that these recommendations are simply averages and they don’t reflect the high degree of weight gain variability in pregnant women.
For example, the retention of extracellular fluid is highly variable in pregnancy; some women accumulate more than 5 liters – or 11 lbs!
These recommendations were derived from a review done by the Institute of Medicine’s Committee on Nutritional Status During Pregnancy and Lactation in 1990. They looked at data from a variety of studies on pregnant women from multiple populations and tried to identify commonalities.
However, weight gain in each of the studies varied substantially, and the “coefficients of variation” of weight gain for women with normal prepregnancy weights ranged from 31 to 63%. A coefficient of variation represents the range of values from the average. So, 63% means that many women’s weights were well above or below the average.
PROBLEMS WITH THE IOM’S WEIGHT GAIN RECOMMENDATIONS
According to the paper, “This degree of variation in gain after controlling for differences in maternal body size shows that maternal prepregnancy weight-for-height status accounts for only a small part of the variation in weight gain.”
In the “clinical implications” section of the report, the IOM explicitly states, “Therefore, recommended gains should be used only as targets and for identifying individuals who should be evaluated for insufficient or excessive rates of gain.”
Evaluation is the keyword here, not implementation. Doctors should use these numbers as a reference, not a rule.
When evaluating a patient, there are SO MANY other factors to take into consideration before making a recommendation.
What is the patient’s weight history? What are their lifestyle habits? Does this patient have any medical conditions? How are their lab values? Does this patient have a history of eating disorders?
The problem is that many doctors simply look at one number — weight gain since the start of pregnancy – and immediately make a conclusion based on this single number.
When reviewing the IOM report, a few other things caught my attention.
One, pre-pregnancy weight-for-height status was usually based on recalled prepregnancy weight and on height measured at the first prenatal visit. If women were incorrect in these recalls, it certainly would affect the outcomes.
I also noticed that frame size and body fat weren’t taken into account. Weight and height are only two pieces of the puzzle when it comes to body composition.
Lastly, weight gain during pregnancy is not as linear as doctors would have you believe. The report showed that average weight gain was about 1 lb per week during the second trimester and 0.9 lbs during the third trimester. That’s not a huge difference, but it does show that slightly more weight is gained in the middle of pregnancy versus the end.
LOW BIRTH WEIGHT VS HIGH BIRTH WEIGHT BABIES
As it turns out, it’s actually better to have a bigger baby than a smaller one. Studies show that low birth weight babies have more birth complications and reach developmental milestones later than larger birth weight babies.
Therefore, you would think that doctors would be more concerned with the fetus gaining weight than with controlling it.
DANGERS OF DIETS DURING PREGNANCY
I’m not the only healthy woman that has been subjected to this. I’ve heard similar stories from many women — some who were actually underweight prepregnancy.
Even someone without an eating disorder would naturally be affected by these comments and start to question themselves.
Am I not doing enough? Should I be exercising more? Should I start counting calories? This is a dangerous line of questioning.
Dieting during pregnancy is a huge no-no according to every major medical association. Dieting during pregnancy has the potential to result in dietary deficiencies of important nutrients for babies like iron, folic acid, and omega-3 fatty acids which could result in poor growth and development or birth complications.
I fully understand that in evaluating a pregnant woman’s health status, a doctor should ask about diet and exercise. But is there perhaps a more sensitive way of doing so that wouldn’t provoke unhealthy thought patterns or behaviors?
Food for thought.
If you’re wondering, I ended up gaining 37 pounds during my pregnancy – a whopping two pounds over the recommendation. Also, Caleb was a week early.
He weighed in at 6 lb 10 oz, on the lower end of the normal 6-9 lb range.
By the time I got home from the hospital, I’d dropped about 27 of those pounds, likely from the babe and a ton of fluid.
Did you hear about my water breaking in Trader Joe’s? There was a lot of it!
Not that any of that matters, because as you’ve just learned, weight gain and loss during and after pregnancy are highly variable. We’re all so different and we can’t be pigeonholed into neat little weight gain categories. All that matters, in the end, is that we have a healthy baby.
It seems to me that pregnant women are much more likely to end up with a healthy baby if their mindset is fostered by positive messages instead of misguided dietary advice.
So if you’re like me, or many other women I know who have been unnecessarily badgered about their weight gain during pregnancy, know that:
- You’re not alone.
- If you’re practicing healthy pregnancy habits, your weight gain is probably just fine.
And for a comprehensive guide on everything you need to know to have a happy, healthy plant-based pregnancy, be sure to check out Plant-Based Juniors’ Predominantly Plant-Based Pregnancy Guide!
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Weigh-in: If you’ve had a child, how did you feel about your weight gain during pregnancy?
*FYI — the doctor in this story was not my main OB who birthed our son (she is amazing). This was a doctor I only saw once for my ultrasound.
Annie vR says:
Thank you so much for sharing this! With my first daughter I really didn’t gain that much weight. Now that I’m pregnant again I’m putting on much more weight and it’s messing with my head. Fortunately my doctors keep reassuring me that I’m doing great, but there’s a small part of me that hates having to look at the scale every time I got to my checkups. So it’s really good to hear that there is so much more to be taken into account than just a number!
Julie @ Running in a Skirt says:
OMG! I’m currently SO ANNOYED for you. I feel like there are SO many things not taken into account like you said. I also feel like all OB offices should hire an RD, like you, to guide people who want help figuring out the appropriate things to eat. With two I’ve gotten so much conflicting information from “experts” on what is right for me and babies I don’t even know what to think. So I’ve decided to just follow intuitive eating and do the best I can!
Stacey Mattinson says:
Oh man. This strikes a chord with me! My OB was really fantastic and said he wasn’t worried at all… but I was worried. I gained 51 pounds during pregnancy and about freaked out (and it wasn’t for lack of trying)! But I learned some important lessons. I think that your body does what it needs to do for baby. Happy, healthy babe now and most of the weight is gone!
Meg says:
Thank you for this article. A similar situation happened to me. I’ve gained 49 pounds and I’m at 34 weeks. I have a history of an eating disorder, and I promised myself I wouldn’t go down that path of counting calories because I know where it can lead. The doctor scheduled me an appointment with a dietitian for “excessive weight gain.” The doctor was so rude about it, like I am intentionally harming my baby somehow. Anyways, thank you again for this article!
Jenn says:
Sometimes I think doctors say things because they think they are “supposed” to say them, not because they actually mean it. It’s maddening really. You look gorgeous in these photos!!
Maria says:
I love this Whitney. I feel like our bodies have a mind of their own sometimes when it comes to pregnancy. I actually didn’t gain very much weight at all, but received judgement that I “wasn’t eating” which was not true at all and actual hurtful at times. We are already continuously needing to adjust to our changing bodies, so I hope everyone (including professionals!) can learn to be a bit more sensitive. :)
Liz says:
Trying again to comment lol! #mombrain But couldn’t love this post more. I definitely had a similar issue and wrote about this too, Given that I started out pregnancy at a higher weight since that’s what my body needed to conceive on my own I hated when the doc brought up numbers!! And lo and behold at 25 weeks the! doc makes a very similar comment to me, and again noting our baby was in the 90th percentile! She was born in the 43rd%ile, healthy and happy, and my body did just what it needed to, even if I did gain a little more.
Kristina says:
Amen to this!! During my gestational diabetes screening I stressed myself out so much that it cause a false high. I took it upon myself to test before and after meals for the next 2 weeks because I freaked out and was so nervous I actually had GDM, but my numbers were far from diabetes. One of th midwives told me that what I did was insufficient and I needed to see a RD or CDE (hello I’m both) to get on a diet and exercise regimen. This freaked me out even more, and she made me feel more stressed and that I wasn’t competent. Luckily I only saw her once and my OB was phenomenal and said I had nothing to worry about (obviously). It’s definitely not fun when you know you’re okay but a professional in the field tells you otherwise!
Deryn Macey says:
Wow, that’s crazy what a doctor said all that. Our bodies really do know best and you look incredibly healthy and happy. And just look at that sweet, little babe. Congratulations! Thanks for sharing this story.
Alexandra Caspero says:
Such a great post! I gained almost 50 pounds during my pregnancy AND I worked out almost every day and ate a mostly plant-based diet. I also showed really early and had a big belly almost the entire time- most of that was the way he was positioned and where I gained the weight. I felt like I constantly had to defend my weight gain to everyone who had a comment on how large I was. Fun times. :) I went until 42 weeks and my son was born at 8 lbs 14 oz, which is still in the “normal” range.
Rachel says:
Thank you so much for this. I’m a 22 year old first time mom, and have been over the recommended weight gain each time. Today at my 26 week appointment, I broke down and sobbed to my doctor who “recommended I start eating low fat, cut back on juice, and work out more often”. I work out 6 days a week, work as a personal trainer, eat a Whole Foods diet, and have a few treats but nothing irregular. She even told me it’ll be hard to lose the weight after I have the baby. I cried the entire way home. I feel like no matter how active or healthy I am my body is still gaining a lot of weight. I see that myself and wish the OB didn’t feel the need to remind me of it.
Bridget @EatRightMama says:
Another wonderful post, Whitney! I hate it when health professionals give advice without prompting with further questions to get the whole picture! In working with moms-to-be I’ve found so much variability in what moms gain and what their babies weigh. So important to go with your gut instincts about what you and your baby need.
Alisa Fleming says:
I would have been irritated too, and I’m not a dietitian! I’m a little confused by the weights though – maybe I’m reading it wrong. Why is the obese weight gain the lowest and the underweight the highest?
Amanda says:
Because underweight women “need” to gain the most, and obese women “need” to gain the least. Underweight women don’t have much fat storage, and obese women have a lot of fat storage. (I’m making grand generalizations here, obviously.) :)
Erin Palinski-Wade says:
Love this and it is SO true! My biggest fear with my first pregnancy should have been my baby’s growth but instead it was always a fear of if my weight would shoot up one week and my doctor would criticize it. Luckily, my doctor was amazing, however one week my weight did increase more than I though and I was so careful watching my portions the next few weeks I lost weight and had to go back for weight checks every few days. Lesson learned LOL. The emphasis should definitely be more on how are you fueling your body vs a fluctuating number based on so many outside variables.
Elissa says:
I would have been so angry too!! This is such valuable information on a little discussed topic. Thank you for sharing, and congratulations!
Lauren Harris-Pincus says:
I feel you! Doctors have no clue and make everything sound so simple. Ugh!
Catherine Brown says:
I’m sorry you had this experience Whitey, and thank you for using it as an opportunity to set the record straight by providing the science. I’m sure many anxieties have been eased.
Katey says:
Thank you for this information and your valuable insight! It is such an important topic and you did an excellent job!
Nico says:
It also *really* bothers me that when a woman is not gaining much weight while pregnant doctors will typically do an ultrasound, check that the baby is growing adequately and then congratulate the woman for “not gaining too much”. As you say, there are bigger detriments to having a smaller baby than a large, there’s the thrifty phenotype that can cause long term health effects in a baby that has had to scavenge for nutrients in utero, and hello – the health of the mother after birth! I’m not sure why that doesn’t count for more. I understand that some women naturally gain less and even if they work hard, they don’t gain the recommended 25lb. But there are also many who are restricting to some degree and that is only worsened by completely thoughtless comments made by many OBs. It takes a lot of energy to birth a baby and then feed them afterward, and if you’re already energy depleted… it makes life as a new mom much more challenging. I really appreciate this post! <3
Whitney E. RD says:
Thanks, Nico. I can see who that would be very upsetting too. Looks like we need a shift across the board in how we look at weight gain during pregnancy!
Becca says:
Thank you for posting this. This morning I was completely fat shamed by a doctor in the practice I was meeting for the first time. I am 5’10, workout 6 days a weeks, eat a balanced and healthy diet, I have a 6-pack at 25 weeks for heaven’s sake and she said the rudest things. I am still in shock after crying most of the day. She thinks I have gained too much weight, too soon and she let me know it! The highlight was when I asked her about our trip to Italy and if she had any concerns, she said, “Nothing other than the usual travel concerns, and of course all the pasta you might eat there.” It was unreal. So thank you. Thank you for posting this. I really appreciate your perspective and it was just what I needed to read.
Isabel B says:
Thank you for this! I just left my appointment aanf was told I’ve gained too much weight and I should not gain anymore. I started out plus sized and so far I’ve gained 12 pounds and am at 24 weeks. Regardless of the scale before getting pregnant I was very active. I still run and go to the gym 3-4 times a week. And while yes I have given in to some cravings, I thought I was eating healthy. This sure feels like a punch in the gut but reading this article has helped.
Kirsten says:
This rung a cord for me too. I was diagnosed as GD . and wasnt being commented on my weight at all. Since i was gaining 1-2 lbs a week. I went to see my diabetes dr.s and one nurse said i gained 2 lbs since my last visit. And now they told me to i need to try and gain half a lb a week by the time i gave birth. Im 34 weeks now.
I felt so bad that ive been off and on with crying and frustrsted by hearing this as i thought i was doing well. Im eating a restricted diet and excersizing as told. But was told i need to exercise a lot more…
Ashley Metled says:
I’m so happy I found this article. I’m currently pregnant with my second and so far I’ve been told the exact same thing with both of my pregnancies, that I need to “slow down”. At one point they had even told me to cut out all carbs from my diet. I was in SHOCK. My starting weight for both of my pregnancies was 123lbs. I gained 35 pounds with my daughter and so far I have gained 25 pounds with this pregnancy. My family lives a very active and busy lifestyle and we take our diets pretty serious, with the occasional splurge. I have noticed my anxiety has skyrocketed since being told yet again I need to “slow down”. I’ve been monitoring my weight and calorie intake so close that it’s caused me to be paranoid. This article is so helpful and reassuring as to just how different each pregnancy is and how different our bodies are. Thank you, THANK YOU, for researching and sharing this. I will be sharing this! ❤️
Whitney E. RD says:
Hi Ashley, I’m so glad you found this article reassuring. It’s unfortunate that pregnant women (who already have enough to worry about) are frequently faced with unnecessary warnings like this. Wishing you a happy, healthy pregnancy!
Ixsharay says:
Thank you very much for this post. Honestly, i’ve dealt with my weight all my life. Since i have a sister with an insanely fast metabolism that makes her even lose weight no matter what she eats, while I had to workout 3 hours a and diet just to mantain my weight, its hard to enjoy my pregnancy when all I hear is how much weight i have gained, specially since I have been watching what I eat, and exercising regularly, and yet I’ve gained 30 pounds at 32 weeks! And just this morning i called him because I’ve had acid reflux and even vomiting because of it, and the only thing I get from him is that I am eating too much and wrong, and to Google a diet for gastric protection and follow it. So yeah. I’m super frustrated
Whitney E. RD says:
I’m so sorry to hear about your struggles but glad this post offered some comfort! Wishing you a happy, healthy pregnancy!
Em says:
This really helped me . Thank you for sharing , as I had a similar experience at 20 weeks with a doctor and also a nutritionist telling me since I gained 20 lbs to slow down . I was 105 pre pregnancy and I’ve never been able to really
Gain weight . I eat so much and I get skinnier and skinnier. Now that I’m pregnant , I am being super cautious what I eat for the babies sake and eat relatively healthy and still workout . I don’t do my normal 5 mile run or even run at all due to my kidney inflammation, but I feel I’m trying my
Absolute best !!!!!! I still am upset about the comments they made and it brought back thoughts of a eating disorder I had when I was much younger . I’m now 30 weeks and have gained 28 lbs . I’m upset about this only because of the stupid doctor and nutritionists careless words !!!!!! Anyways – I’m short so maybe that is it x it’s near impossible to slow Weight gain during pregnancy. I’m mad writing this !! Ok thanks for the post
Addysmama says:
Thank you for posting this. I have always been mindful of my figure and have tried to eat well and work out regularly. The summer before I got pregnant, I gained about 10 pounds. I think a lot of it was muscle because I was working out more, but I stillfelt bad. I am 20 weeks pregnant now and have gained 15 pounds (exactly where you were at at this ultrasound!) and I sometimes worry about “getting my body back” post baby since I already gained 10 pounds before the pregnancy. It also looks highly likely that my baby will be born big. She is already a pound, when most are 10oz at this stage, and my husband and I were both big babies. This was a very reassuring to me. My baby is doing really well—really healthy and really active. She’s kicking as I type this. It makes a lot of sense that there is tons of variability and that the 15-35lb range should just be a reference not a rule. Thanks again
Michelle says:
I’m on my eighth pregnancy and have gained 40-50 pounds with each one. I am always able to loose it easily afterward, so I have just accepted that this is my normal. My doctor understands, too. Never had blood pressure problems, preeclampsia or gestational diabetes. I tend to have a lot of fluid, too! One time the doctor broke my water himself and had the pan all ready to go to catch everything. It overflowed everywhere; he couldn’t believe it!
Johanna Stebbins says:
Thank you for this post! I have been eating a healthy diet, still running 4-6 miles 5 times a week, hitting 10k steps every day, and I have gained 15 pounds by 24 weeks. I am 5’2 but was bodybuilding previously to this pregnancy. I have felt so nervous coming to the 20 pound benchmark a doctor set for me as a “goal”. My OB is fantastic, but that number always comes up in my head. Glad to hear I’m not the only one whom it frustrates!
Renee says:
Thank you so much for this article (and the reassuring comments). I asked my OB providers repeatedly about my weight gain during my 1st and 2nd trimester and was assured I was doing fine. I was finally feeling good about my pregnant body and was pretty proud at my 30 week checkup when the doctor casually asked how much weight I’ve gained. I replied, “exactly 20 lbs.” He then suggested I avoid gaining any more weight for the rest of my pregnancy. Having dealt with an eating disorder and fighting my weight my whole life, I was devastated. I went home hating myself, feeling like a complete failure. I could feel myself sliding into the, “I hate myself. I’m just going to stop eating” mentality, but I know objectively that would be the wrong thing to do for my baby. Your article and the comments reminded me that I need to just listen to my body and focus on feeling well, not obsessing about a number on the scale regardless of my doctor’s comments. All of my other stats a perfect and my baby is healthy. My body is doing what it needs to in order to have a successful pregnancy.
Ella says:
Such a good post. I had an ED for years (like 15 years) and now I’m finally recovered and healthy I decline to let the doctors and midwives weigh me during pregnancy. I find it’s too much of a risk and so long as I know I’m eating healthily and exercising the right amount, my weight is irrelevant. I actually think it’s mad to weigh pregnant women all the time – for a start, you can see if someone is an unhealthy weight either way just by looking and weight is so different to the reality of fitness and health. I carry lots of fluid when pregnant, but over a couple of weeks after birth that all goes. Babies weight never really corresponds with mums weight gain, despite the medical focus on it. I think if we focused on health, good diet and exercise instead of weight, it would be far far better. Thanks for this post.
Adriana says:
I don’t know if you’ll read this comment so many years later but I wanted to say thank you. For the vast majority of my pregnancy I’ve had a wonderful obgyn who never said anything about my weight. He unfortunately left my practice and in my last 2 visits I saw a midwife who is OBSESSED with my weight gain. I’m at +22lbs at week 28, working out 4-5 days a week, gardening on the weekend, I eat lots of greens and fruit and no junk food and I’m a scientist who understands statistics. A look at her tells you she suffers from an eating disorder, she admitted she does WW and believe me, she doesn’t need it. I have perfect blood work and blood pressure and feel really good. I’ve let her get in my head and poison me. I will never see her again during my pregnancy. Your post made me tear up and made me feel so much better.
ML says:
This is so incredibly wholesome. It’s good to see other mamas who have overcome that feeling of defeat. You’ve got this! ♥️
Christina says:
Thank you so much for posting this! I’m bookmarking this so I can reread it as needed for this pregnancy. I have an unspecified eating disorder that has bordered on obsessive in the past. I weighed 120 Ibs when I got pregnant with my first baby, weighed 190 Ibs when he was born (he came out 6 Ibs 12 oz; 20 Ibs of that was fluid retention that I lost after 1w of taking a water pill), and weighed 155 Ibs 6m postpartum. That was 5 yrs ago. My 2nd/current pregnancy: I weighed about 160 Ibs when I got pregnant and now weigh 184 Ibs at 19w. I’m worried because according to the charts, I’m gaining WAY too much WAY too fast. I didn’t exercise with my 1st but I am with this one (25m a day). I didn’t pay attention to what I was eating and ate as much as I wanted with my 1st, and I kept drinking soda; this one I’m not eating as much, only when I’m absolutely hungry, eating healthier, and only drinking water.
I don’t know if I should be worried or if it’s society telling me I should worry!
Sammi says:
I am so glad I came across this! I am 19 weeks 4 days with my first baby and had my anatomy scan today. I have gained 12 pounds and my Dr. told me I should start watching my carbs. Mind you, she has never asked me about my diet. She asks about exercise but not once about diet. So she is just assuming carbs are a problem. I’m pretty sure at my first appointment she told me the goal was 25-35 pounds but then today she mentioned 25 pounds being ideal and how I’m already half way there. So thank you for this post and putting my mind at ease!
ML says:
Thank you for addressing this. I had my 24 week appt the other day and gained 6 lbs since my last appointment 4 weeks ago—2 pounds over mark. I also guesstimated how much I weighed pre-pregnancy. The ultrasound was great; the tech and OB both said how healthy baby was.
Then the comment was made. “Just be mindful of your weight.”
I paused momentarily, and then informed her that my clothes still fit; that my diet hadn’t changed; that I eat whole grains and fruits and veggies and homemade meals that are nutritious; I don’t exercise as much as I did pre-pregnancy, but I’m not stagnant; for Pete’s sake—MY CLOTHES STILL FIT!
She simply said, “you go girl, but be mindful of that weight gain.” And I left the office so defeated. Am I harming my baby? Am I doing something wrong? I’ve calorie counted since I was 20 years old; it’s a dangerous habit I can’t break. Unfortunately for me, I still calorie count during pregnancy, but I eat until I’m comfortably full. The number doesn’t fluctuate much, and if it does, it’s a day or a week, and then it tapers off. So I know I’m not doing anything more or less than what I was before.
The OB’s only response was that many women don’t like the scale there. But I still never got a clear answer or reason for why the comment was made. And now, a whole 48 hour later, I still feel guilty to eat, too big, and in the wrong for being 2 lbs over “goal.” At least, I’m assuming that’s what she meant? It was never fully disclosed; just a blanketed comment that hurt deeply. Why would I ever do anything to hurt our baby, and why in the world would a comment like that be positive motivation to take good care of myself? If anything, it urges me back to a place I left behind, save for calorie counting. So for all you moms out there who have experienced this, how’d you get over that feeling of defeat and worthlessness?
Tina says:
I know this post is older and I’m just finding it now, but as a Registered Nurse, the fact that a doctor who didn’t know you and wasn’t your personal physician felt they had any right to comment on your health at all is amazing to me. That was extremely unprofessional and potentially harmful. I have had horrible experiences with all three of my pregnancies when it came to my weight that resulted in missed diagnosis that could have resulted in the death of me or my unborn babies. Despite starting all three pregnancies at a normal weight, I gained weight easily and quickly. I even dieted through my entire second pregnancy and still gained 65 pounds. During my first pregnancy, I gained 75 pounds. I had hypertension and ended up requiring emergency induction at 38.5 weeks due to my blood pressure. The entire pregnancy, I did not eat any differently than I always did (had always been able to maintain a normal, healthy weight prior to pregnancy). My midwife told me I would have difficulty losing the weight because I’d gained so much. But that was not the case. Despite not being able to breastfeed because I didn’t produce any milk (for an unknown reason that they did not investigate) I lost all 75 pounds without dieting or exercise in less than 4 months. I also lost patches of my hair and had significant joint pain that interfered with my daily life, and extreme fatigue. My second pregnancy was easier, no blood pressure issues, but despite caloric restriction through the entire thing, I still gained 65 pounds. Despite being born at 41 weeks gestation, my baby was a small 6lb11oz and 18 inches. Smaller than my first baby who was 7lb 3 oz and born at 38 weeks. I believe he was smaller because of my calorie restriction throughout the pregnancy. Again, the doctor said it would be hard to lose, but it was not. I again could not breastfeed, had extreme joint pain, extreme fatigue, ended up with a pulmonary embolism a few weeks after delivery, and lost all the weight without dieting or exercise in under 4 months. Then the third pregnancy…Again with the blood pressure, this time with blood thinners to prevent a clot and aspirin. Again with the 75 pound weight gain that they said I wouldn’t lose despite this being historically inaccurate. I didn’t listen to them this time and ate what I wanted when I wanted. After delivery all the same symptoms: fatigue, joint pain, extremely fast weightloss without trying. Finally, a doctor was willing to look into my issues and discovered that I had pregnancy induced thyroiditis. During my pregnancies, my thyroid would be underactive, after pregnancy it would rev up and be over-active. I had thyroid antibodies, suggesting possible autoimmune disorder. If any one of my three obstetricians had bothered to consider a physiological reason for my weight gain and subsequent issues and not just assumed I was eating too much, I could maybe have prevented a ton of anguish. Not to mention, I was blessed and lucky that my thyroid disorder didn’t result in miscarriages. It is super irresponsible for any doctor to assume that “excessive” weight gain during pregnancy is always the fault of the woman eating too much. This was certainly not the case during any of my pregnancies.
Myra says:
Thank you for this. My pre pregnancy weight was 115-120 lbs and I easily fluctuated 3 lbs in a day. I am now 31 weeks along and live a very active lifestyle and EVERY time I go into the OBGYN (nurse practitioner) she tells me I am gaining to much weight to fast. I still wear size small maternity clothes, and mediums in regular t-shirts. And I am known to obsess about my weight and exercise somewhat. Being pregnant has decreased my amount of exercise that I can do and when my doctor told me I was gaining weight to fast I immediately went to the place in my head that I needed to exercise more and only eat salads. Everyone around me says she is crazy and my actual dr has no problem with my weight gain. But every time I see this OBgyn she has to mention slowing down on weight gain and it is sooo detrimental to my mental eating health. All I want to do is be healthy and have a healthy baby.
Rosalie says:
It’s great that you share your experience, it is very valuable, and will definitely help those who are now going through this amazing stage. Of course, in all matters that relate to your pregnancy, it is always first of all necessary to consult with your doctor. Especially if your pregnancy is special. After all, not everyone can get pregnant for health reasons, but there are many reliable ways to help you do this. I advise you here to learn more about the ARK Cryo service, one of the most reliable experts in the field of frozen egg transport
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Katie says:
This post was written around the time I was diagnosed with anorexia at age 21. The biggest thing to pull me out of a life-threatening eating disorder was the fear that, one day, when I was trying to conceive or was pregnant, I would be infertile or put my baby in danger. 5 years later, I’m 20 weeks pregnant with my baby boy. The doctor I saw yesterday (not my primary OB) was very critical of my weight gain and prodded me about what/how much I was eating. Then of course he looked down at my file and saw “anorexia” and reverted to telling me I need to come in again for another in-depth anatomical scan of the baby at 32 weeks because my history of anorexia could cause baby to be underdeveloped (right now baby is a little above average for growth and overall healthy). What?
I was hysterical for hours after the appointment and am still struggling to focus at work today because I can’t stop thinking about the food I’m putting into my body and wanting to poke and prod my legs where some of the extra weight has gone. I had a body scan done a month before I got pregnant. I was just barely within the healthy weight range, but my muscle and fat percentages were both considered too low. I have worked so hard to give my baby all of the nutrients, not restricting. I didn’t question my weight gain because I am 5’1 and petite, as people constantly like to tell me when referring to my cute, rapidly growing belly .
I should get back to work, but this is all I can think about. I don’t know what to do. I’m planning to talk to my primary OB this week to see if he has any concerns regarding my weight gain. I can’t afford to spiral again, not now with this baby boy inside my belly.
Katie says:
TO CLARIFY, THE DOCTOR WAS SAYING I HAVE GAINED WAY TOO MUCH WEIGHT.
Kate says:
Thanks for sharing your experience! The woman and her loved ones also need to prepare psychologically for childbirth. Thanks to birthing classes https://www.magnoliabirthhouse.com/childbirth-classes , this can be done in a much more comfortable format. It is important for a woman to choose the maternity hospital in which she will give birth and discuss all concerns with an obstetrician-gynecologist.
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